Exercise Program Waiver and Release Form
Please read the following waiver and release carefully before participating in the group exercise program at House of Jai.
I have enrolled in the group exercise program offered by Jill Messite at House of Jai. I recognize that the class may involve strenuous physical activity including, but not limited to, muscle strength and endurance training, cardiovascular conditioning and training, and other various fitness activities. I hereby affirm that I am in good physical condition and do not suffer from any known disability or condition which would prevent or limit my participation in this exercise program. I acknowledge that my enrollment and subsequent participation is purely voluntary and in no way mandated by Jill Messite or House of Jai.
In consideration of my participation in this program, I hereby release Jill Messite and House of Jai and its agents from any claims, demands, and causes of action as a result of my voluntary participation and enrollment.
I fully understand that I may injure myself as a result of my enrollment and subsequent participation in this class and I hereby release Jill Messite and House of Jai and its agents from any liability now or in the future for conditions that I may obtain. These conditions may include, but are not limited to, heart attacks, muscle strains, muscle pulls, muscle tears, broken bones, shin splints, heat prostration, injuries to knees, injuries to back, injuries to foot, or any other illness or soreness that I may incur, including death.
Full Name
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First Name
Last Name
Email Address
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example@example.com
Phone Number
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Please enter a valid phone number.
Format: (000) 000-0000.
I HEREBY AFFIRM THAT I HAVE READ AND FULLY UNDERSTAND THE ABOVE STATEMENTS.
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